title: Moderate acoustic changes can disrupt the sleep of very preterm infants in their incubators.
abstract: OBJECTIVE
  To evaluate the impact of moderate noise on the sleep of very early preterm infants (VPI).
  
  
  METHODS
  Observational study of 26 VPI of 26-31 weeks' gestation, with prospective measurements of sound pressure level and concomitant video records. Sound peaks were identified and classified according to their signal-to-noise ratio (SNR) above background noise. Prechtl's arousal states during sound peaks were assessed by two observers blinded to the purpose of the study. Changes in sleep/arousal states following sound peaks were compared with spontaneous changes during randomly selected periods without sound peaks.
  
  
  RESULTS
  We identified 598 isolated sound peaks (5 ≤ SNR < 10 decibel slow response A (dBA), n = 518; 10 ≤ SNR < 15 dBA, n = 80) during sleep. Awakenings were observed during 33.8% (95% CI, 24-43.7%) of exposures to sound peaks of 5-10 dBA SNR and 39.7% (95% CI, 26-53.3%) of exposures to sound peaks of SNR 10-15 dBA, but only 11.7% (95% CI, 6.2-17.1%) of control periods. The proportions of awakenings following sound peaks were higher than the proportions of arousals during control periods (p < 0.005).
  
  
  CONCLUSIONS
  Moderate acoustic changes can disrupt the sleep of VPI, and efficient sound abatement measures are needed.
authors.affiliation: Laboratoire d'Imagerie & Neurosciences Cognitives, UMR 7237 Université de Strasbourg/Centre National de la Recherche Scientifique, Strasbourg, France. pierre.kuhn@chru-strasbourg.fr
authors.forename: Pierre
authors.initials: P
authors.lastname: Kuhn
authors.forename: Claire
authors.initials: C
authors.lastname: Zores
authors.forename: Claire
authors.initials: C
authors.lastname: Langlet
authors.forename: Benoît
authors.initials: B
authors.lastname: Escande
authors.forename: Dominique
authors.initials: D
authors.lastname: Astruc
authors.forename: André
authors.initials: A
authors.lastname: Dufour
mesh_terms: D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007186:Incubators, Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D007363:Intensive Care Units, Neonatal; D008297:Male; D009622:Noise / Q000009:adverse effects*; D011446:Prospective Studies; D059629:Signal-To-Noise Ratio; D012890:Sleep / Q000502:physiology*; D014741:Video Recording; D014851:Wakefulness / Q000502:physiology*
keywords: Arousal; Noise; Preterm newborns; Signal-to-noise ratio; Sleep